Nasal corticosteroid sprays

This medicine is sprayed into the nose to reduce inflammation and its symptoms such as nasal stuffiness.

A nasal corticosteroid spray reduces swelling and mucus in the nasal passageway. The sprays work well for treating:

• Allergic rhinitis symptoms, such as congestion, runny nose, sneezing, itching, or swelling of the nasal passageway
• Nasal polyps, which are noncancerous (benign) growths in the lining of the nasal passage

A nasal corticosteroid spray is different from other nasal sprays you can buy at the store to relieve symptoms of a cold.

A corticosteroid spray works best when it is used every day. Your health care provider will recommend a daily schedule of the number of sprays for each nostril.

You may also use the spray only when you need it, or as needed along with regular use. Regular use gives you better results.

It may take 2 weeks or more for your symptoms to improve. Be patient. Relieving the symptoms can help you feel and sleep better and lessen your symptoms during the day.

Starting a corticosteroid spray at the beginning of pollen season will work best for decreasing symptoms during that season.

Several brands of nasal corticosteroid sprays are available. They all have similar effects. Some require a prescription, but you can buy some without one.

Make sure you understand your dosing instructions. Spray only the number of prescribed sprays in each nostril. Read the package instructions before using your spray the first time.

Most corticosteroid sprays suggest the following steps:

• Wash your hands well.
• Gently blow your nose to clear the passageway.
• Shake the container several times.
• Keep your head upright. Don't tilt your head back.
• Breathe out.
• Block one nostril with your finger.
• Insert the nasal applicator into the other nostril.
• Aim the spray toward the outer wall of the nostril.
• Inhale slowly through the nose and press the spray applicator.
• Breathe out and repeat to apply the prescribed number of sprays.
• Repeat these steps for the other nostril.

Avoid sneezing or blowing your nose right after spraying.

Nasal corticosteroid sprays are safe for all adults. Some types are safe for children (age 2 and older). Pregnant women can safely use corticosteroid sprays. Your provider will recommend which ones have the best safety record in pregnancy.

The sprays usually work only in the nasal passageway. They do not affect other parts of your body unless you use too much.

Side effects may include any of these symptoms:

• Dryness, burning, or stinging in the nasal passage. You can lessen this effect by using the spray after showering or placing your head over a steamy sink for 5 to 10 minutes.
• Sneezing.
• Throat irritation.
• Headaches and nosebleed (uncommon, but report these to your provider right away).
• Infection in the nasal passages.
• In rare cases, perforation (hole or crack) in the nasal passageway may occur. This can happen if you spray into the middle of your nose instead of toward the outer wall.

Make sure you or your child uses the spray exactly as prescribed to avoid side effects. If you or your child uses the spray regularly, ask your provider to examine your nasal passages now and then to make sure problems are not developing.

Contact your provider if you have:

• Nasal irritation, bleeding, or other new nasal symptoms
• Continued allergy symptoms after repeated use of nasal corticosteroids
• Questions or concerns about your symptoms
• Trouble using the medicine

Steroid nasal sprays; Allergies - nasal corticosteroid sprays

American Academy of Family Physicians website. Nasal sprays: how to use them correctly. familydoctor.org/nasal-sprays-how-to-use-them-correctly. Updated September 2023. Accessed January 2024.

Corren J, Baroody FM, Togias A. Allergic and nonallergic rhinitis. In: Burks AW, Holgate ST, O'Hehir RE, et al, eds. Middleton's Allergy: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 40.

Seidman MD, Gurgel RK, Lin SY, et al; Guideline Otolaryngology Development Group. AAO-HNSF. Clinical practice guideline: allergic rhinitis. Otolaryngol Head Neck Surg. 2015;152(1 Suppl):S1-S43. PMID: 25644617 pubmed.ncbi.nlm.nih.gov/25644617/.

Updated by: Stuart I. Henochowicz, MD, FACP, Clinical Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, Georgetown University Medical School, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.